31 Med. Sci. & L. 2 (1991)

handle is hein.journals/mdsclw31 and id is 1 raw text is: 





2 Med. Sci. Law (1991) Vol. 31, No. 1


Editorial


NEVILLE DAVIS, FRCGP FFOM
Immediate Past-President, Section of Clinical Forensic Medicine, the Royal Society of Medicine


Not all that long ago Professor David Gee
described the newly-qualified UK doctors as
'forensically illiterate'. The generally poor
rating given to the importance of forensic
medicine in undergraduate curricula has in-
evitably resulted in a situation where many
doctors lack even the basic knowledge required
to describe wounds accurately and the ability to
draw reasonable conclusions as to their causa-
tion. As to their medical obligations under the
law, ignorance appears to be widespread, great-
ly to the dismay of the medical defence bodies
and no doubt now also to the Department of
Health.
   Working closely with the law enforcement
agencies, the Association of Police Surgeons
(APS) has always striven to raise the clinical
standards of its members, and its efforts have
not been in vain, but not all police surgeons are
members of APS. The Metropolitan Police has
for some years conducted in-house courses for
its forensic medical examiners, both for induc-
tion and for updating in the light of changing
legislation and technical progress. There is also
a form of peer assessment undertaken prior to
establishment.   Elsewhere   several   con-
stabularies are following similar lines and
early this year the Association of Chief Police
Officers (ACPO) organized for the first time a
course at Bramshill Staff College open to any
doctor in contract with police. An awareness of
the problem of marked variations in standards
is accepted, but ACPO has in the past shied
away from introducing mandatory assessment
of police surgeons, presumably because of
recruitment difficulties in many areas, so there
is no real pressure to undertake post-graduate
training. The General Medical Council appears
to be unhappy about allocating precious time in


the undergraduate curriculum to medico-legal
instruction at the expense of other subjects, so
the undergraduate scene is unlikely to change.
   APS members are encouraged to take the
DMJ(Clin), but the uptake is poor, with only
about 10% of its members holding the diploma.
There is, in fact, no accredited post-graduate
qualification in legal medicine, and any doctor
may claim to be a medico-legal expert, discon-
certing to the lawyers and especially to the
courts, both civil and criminal, who have to
assess the weight of medical evidence.
   The Royal College of Physicians of London
has this year established a Standing Commit-
tee on the Legal Aspects of Medicine (CLAM),
charged to investigate the academic status of
the medico-legal interface and to make recom-
mendations. The committee has not yet
reported, but it is clear that the need for im-
provement has been identified, both for doctors
in general and for those doctors such as police
surgeons and their defence counterparts,
prison medical officers, doctors assessing in-
juries  in  civil compensation   cases, or
investigating alleged medical negligence and
similar matters. The special academic needs of
prison medical officers are being considered
concurrently by a working party involving
three Royal Colleges, the Physicians, the
Psychiatrists and the General Practitioners
together with the Prison Medical Directorate.
   It is likely that a working party set up by
CLAM will recommend to its parent committee
the establishment of a basic certificate in legal
medicine, to be obtained after satisfactory com-
pletion of a course whose syllabus will include
all those   medico-legal matters   hitherto
neglected in the undergraduate curriculum, to
the level which should reasonably be expected

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